Route 4 Auto Exchange

Please enter the information requested on this page to apply for vehicle financing. Items marked in red are required without exception.

Applicant

Applicant type

Cosigner for

First name

Middle initial

Last name

Email address

Street address

Apartment # or suite

Zip code

City

State

Phone #Cell phoneLand line

Work phone #

Social security #

Date of birth

Driver's license state

Housing

Do you rent or own?Own (no mortgage)Buying (have mortgage)RentLive with familyOther

Monthly payment

Time at current residence

Previous residence

If living at current residence for less than two years, please provide:

Street address

Apartment # or suite

Zip code

City

State

Time at residence

Employment details

Place of employment

Occupation

Work street address

Work apartment # or suite

Work zip code

Work city

Work state

Business phone

Employment length

Gross salaryWeeklyBi-weeklyMonthlyAnnually

Other incomeWeeklyBi-weeklyMonthlyAnnually

Other income source

Previous employer details

If current employment is less than two years, please provide:

Occupation

Place of employment

Phone #

Street address

Apartment # or suite

Zip code

City

State

Length of employment

Finance history

Do you have another car loan?

Have you ever experienced repossession?

If so, when?

Co-applicant

I have a loan co-signer

Relation to cosignerSpouseFamilyFriendOther

Vehicle to finance

Vehicle of interest

Cash down

I have a trade-in

Trade-in year

Trade-in make

Trade-in model

Amount owed on trade

Additional information

Comments

Important privacy information

By submitting this application, you are authorizing us to share the information you provide on this page with non-affiliated third parties in order to determine your creditworthiness and secure automobile financing.

We may collect information about you from one or more consumer reporting agencies, employers, references or insurance companies. We restrict access to information about you to employees who need to know that information in order to provide products or services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to protect your data.

We may disclose all of the information we collect, to companies that perform marketing services on our behalf or to other financial institutions with whom we have joint marketing agreements. We may make such disclosures about you as a consumer, customer, or former customer. We may also disclose nonpublic personal information about you as a consumer, customer or former customer, to nonaffiliated third parties as permitted by law.

I agree with the terms above, and request that my creditworthiness be evaluated, at no cost to me, in order to determine the types and extent of financing available.